title: Comparison of tulathromycin, azithromycin and azithromycin-rifampin for the treatment of mild pneumonia associated with Rhodococcus equi.
abstract: The objectives of the present study were to determine the relative efficacy of tulathromycin, azithromycin, or azithromycin with rifampin for the treatment of pulmonary abscesses on a farm with endemic infections caused by Rhodococcus equi. Foals with ultrasonographic evidence of pulmonary abscesses (abscess score 8.0-15 cm; n=120) were randomly allocated in four equal treatment groups: (1) tulathromycin intramuscularly; (2) azithromycin monotherapy, orally; (3) azithromycin with rifampin, orally; (4) saline intramuscularly as a placebo. Physical examination and thoracic ultrasonography were performed by individuals unaware of treatment group assignment. Foals that worsened were removed from the study. The proportion of foals that recovered without the need for a change in therapy was significantly higher for foals treated with azithromycin (29 of 30) or azithromycin with rifampin (28 of 30) than for foals treated with a placebo (20 of 30). Additionally, azithromycin or azithromycin with rifampin resulted in a significantly faster decrease in the number of abscesses and abscess score compared with a placebo. The proportion of foals treated with tulathromycin that recovered (27 of 30) was not significantly different from that of foals treated with a placebo. Azithromycin alone or in combination with rifampin was beneficial in the study population.
authors.affiliation: Veterinary Clinic, Trift 4, Destedt 38162, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Venner
authors.forename: N
authors.initials: N
authors.lastname: Credner
authors.forename: M
authors.initials: M
authors.lastname: Lämmer
authors.forename: S
authors.initials: S
authors.lastname: Giguère
mesh_terms: D000193:Actinomycetales Infections / Q000188:drug therapy / Q000453:epidemiology / Q000662:veterinary*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D004187:Disaccharides / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination / Q000662:veterinary; D019353:Endemic Diseases / Q000662:veterinary*; D005858:Germany / Q000453:epidemiology; D006571:Heterocyclic Compounds / Q000627:therapeutic use*; D006734:Horse Diseases / Q000188:drug therapy* / Q000453:epidemiology; D006736:Horses; D008169:Lung Abscess / Q000188:drug therapy / Q000662:veterinary*; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000382:microbiology / Q000662:veterinary*; D016929:Rhodococcus equi; D012293:Rifampin / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018942:Macrolides
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin; D004187:Disaccharides; D006571:Heterocyclic Compounds; D012293:Rifampin; C485204:tulathromycin; D018942:Macrolides
keywords: Pneumonia; Respiratory disease; Rhodococcus equi